Trends with neoadjuvant radiotherapy and clinical staging for those with rectal malignancies

World Journal of Gastrointestinal Surgery
Sanjay S ReddyElin R Sigurdson

Abstract

To see how patterns of care changed over time, and how institution type effected these decisions. A retrospective analysis was performed using the National Cancer Database, looking at all patients that were diagnosed with rectal cancer from 1998 to 2011. We tested differences in rates of treatment and stage migration using χ(2) tests and logistic regression models. A review of ninety thousand five hundred and ninety four subjects underwent multimodality therapy for cancer of the rectum. Staging and response to treatment varied greatly between centers. Forty-six percent of the time staging was missing in academic practices, vs fifty-four percent of the time in community centers (P < 0.001). As a result, twenty-percent were down-staged and eight percent up-staged in academia, whereas only fifteen percent were down-staged and 8% up-staged in community practices (P < 0.001). Forty-two percent of individuals underwent radiation before surgery in 1998. Within two years this increased to fifty-three percent. This increased to eighty-six percent by 2011 (P < 0.001). Institution specific treatment varied greatly. Fifty-one percent received therapy before surgery in academic centers in 1998. Thirty-nine percent followed this pattern in t...Continue Reading

Citations

May 12, 2018·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·G ArmstrongD Jayne
Oct 31, 2017·Cancer Research and Treatment : Official Journal of Korean Cancer Association·Hae Jin ParkYoon Kim
May 3, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·N P McKennaK L Mathis

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